October 2005

Information

Integrated Strategy on Healthy Living and Chronic Disease

New Federal Investments in Cancer Control

Through the Integrated Strategy on Healthy Living and Chronic Disease, the Government of Canada will contribute $59.5 million over five years to the Canadian Strategy for Cancer Control (CSCC). This funding will increase to $17.5 million annually in 2009-10 and beyond. The Government's contribution will build on existing federal program activities that contribute to cancer prevention, control and coordination. (See "Integrated Cancer Funding" for more details.)

The World Health Organization has proposed that cancer should be managed within the context of a national cancer program. The need for a collaborative approach to cancer control that provides coherence in the investments made by multiple jurisdictions and partners is recognized in Canada. The federal government sees the importance of a national strategic approach to cancer control and values the combined expertise and experience of all jurisdictions and organizations involved in this activity.

During the planning stage of the CSCC, the federal, provincial and territorial governments along with stakeholders, such as the Canadian Cancer Society and organizations representing cancer patients, worked together to identify strategic priority areas. The seven areas agreed on are: primary prevention; rebalancing the focus of cancer care to put more emphasis on patients and families; surveillance and analysis; standards; clinical practice guidelines; health human resources; and research.

Taken together, the strategic priority areas represent a comprehensive approach to cancer control that considers the need to promote health and prevent cancer, detect this disease as early as possible when it does occur, and provide care and support to patients and families who are coping with the disease, including at the end of life. Understanding as much as possible about cancer and its social and economic burden is also key.

Current Investments

All partners in cancer control in Canada have a role to play in the strategic priority areas of the CSCC. The federal government plays a part in each of these areas; it already makes very significant contributions through major initiatives such as tobacco control and work with the provinces and territories on health care issues such as wait times for treatment, the availability of health human resources and palliative care, cancer surveillance, cancer research funding and cancer research infrastructure.

Integrated Strategy Contributions

The Integrated Strategy on Healthy Living and Chronic Disease will advance the CSCC's strategic priority areas in several ways. In addition to its cancer-specific elements, the Integrated Strategy provides for integrated chronic disease initiatives such as an observatory of best practices ("what works") in health promotion and chronic disease prevention, and demonstration projects to allow provinces and territories to test different approaches to integration and compare experiences. Lessons learned in Canada and in other countries in combatting other chronic diseases can benefit cancer control and vice versa. Federal health promotion efforts, under the pan-Canadian Healthy Living Strategy, that help change societal factors that influence the risk of developing cancer and other chronic diseases - such as supports for healthy eating and physical activity - will also contribute to cancer control.

New Cancer-Specific Investments

New investments will be directed to five of the CSCC's seven strategic priority areas, based on where the federal government can have the most impact at this time, given available resources. As these initiatives are put in place and produce results, additional new investments can be considered.

Primary prevention: This element recognizes that some risk factors are unique to cancer, such as exposure to the sun. In conjunction with partners, there will be support for efforts to increase cancer avoidance at the national, provincial/territorial, regional and community levels. Canadians will benefit directly from public awareness activities and community-based programs as well as indirectly from measures to increase cancer prevention skill sets among the health practitioners and community health workers with whom they interact. Groups at higher risk for cancer, for example those with high sun exposure, will receive particular attention.

Rebalanced focus: More needs to be done for people living with cancer, their families, and their communities to help them cope with the impacts of the disease not just on their physical health but also on their psychosocial well-being. In collaboration with partners, supports like community-based patient networks and Web-based tools will be offered to patients to help them navigate their way through the complexities of cancer treatment. Efforts will also be made to support the skill sets of health practitioners and community health workers so that they are better prepared to help patients.

Surveillance and analysis: The federal government will work with provinces and territories, provincial cancer registries, cancer centres and children's hospitals to improve the ability to analyse and interpret data about cancer risk factors, staging, follow-up and palliative care. This would include enhancing existing registries and databases, which is another means of getting a clearer picture of cancer in Canada. Support will be provided to provinces and territories to build their capacity to provide cancer-related information and analysis for enhanced chronic disease surveillance.

Standards and guidelines: The federal government will champion a pan-Canadian process to support ongoing cooperation among provincial cancer programs, health service providers, professional associations, communities of patients/survivors/caregivers, communities of practice, communities of researchers and non-governmental stakeholders to develop standards (what is expected in cancer interventions) and guidelines (how to carry out cancer interventions). Standards and guidelines must be based on scientific and medical evidence, and the extent to which they are implemented and improving health results for Canadians must be evaluated.

Working Together

Given Canada's rich history in the area of cancer control and the significant investment of its effort, since 1999, in the planning of the CSCC, it is well positioned to adopt a truly national strategy for cancer control. Since the federal and provincial/territorial governments share responsibilities in the area of health, this matter will have to be jointly considered by both levels of government. The Pan-Canadian Public Health Network, currently being developed by the Public Health Agency of Canada in conjunction with the provinces and territories, should be instrumental in moving this issue forward.